Advanced donor age does not increase risk of hepatocellular carcinoma recurrence after liver transplantation: a retrospective two-center analysis using competing risk analysis
Résumé
The impact of donor age on the recurrence of hepatocellular carcinoma (HCC) after liver transplantation is still debated. Between 2002-2014, all patients transplanted for HCC in 2 European liver transplantation tertiary centers, were retrospectively reviewed. Risks factors for HCC recurrence were assessed using competing risk analysis and the impact of donor age < or ≥65 years and < or ≥80 years was specifically evaluated after propensity score matching.728 patients transplanted with a median follow up of 86 months were analysed. The 1, 3, and 5-year recurrence rates were 4.9%, 10.7% and 13.9% respectively. In mutivariable analysis, recipient age (sHR: 0.96 [0.93 ; 0.98], p<0,01), number of lesions (sHR: 1.05 [1.04 ; 1.06], p<0.001), maximum size of the lesions (sHR: 1.37 [1.27 ; 1.48], p<0.01), presence of a hepatocholangiocarcinoma (sHR: 6.47 [2.91; 14.38], p<0.01) and microvascular invasion (sHR: 3.48 [2.42; 5.02], p<0.01) were significantly associated with HCC recurrence. After propensity score matching, neither donor age ≥65 (p=0.29) nor donor age ≥80 (p=0.84) years increased the risk of HCC recurrence. In conclusion, donor age was not found to be a risk factor for HCC recurrence. Patients listed for HCC can receive a graft from an elderly donor without compromising the outcome.
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